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Condition

Frozen shoulder

A common cause of a painful, stiff shoulder that develops gradually, and one where targeted treatment can ease pain and restore movement

Frozen shoulder, also called adhesive capsulitis, is a condition in which the shoulder becomes painful and progressively stiff, limiting movement. It tends to develop in stages over many months and usually improves with time, but the process can be slow and uncomfortable, and the right treatment can help considerably along the way.

Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928).

Common symptoms

Frozen shoulder typically follows a pattern of stages. Features include:

  • Shoulder pain that develops gradually, often worse at night
  • Increasing stiffness and a reducing range of movement
  • Difficulty with everyday actions such as reaching up or behind the back
  • A later phase in which movement slowly returns

How it is diagnosed

Frozen shoulder can usually be recognised from the history and a careful examination of the shoulder's movement. Part of the assessment is making sure the symptoms are not due to another shoulder problem, as this guides the right treatment.

Ultrasound can help assess the shoulder and exclude other causes of pain and stiffness. Dr Borukhson uses point-of-care ultrasound during the consultation, so the shoulder can often be examined in the same visit. You can read more on the ultrasound clinic page. Where she judges another type of imaging to be more appropriate, such as an MRI, she will refer for it, and at times both ultrasound and MRI are needed together to build a complete picture.

How it is treated

The aims are to relieve pain and restore movement. Treatment usually combines a structured programme of exercises to maintain and recover movement with measures to control pain. Where pain is limiting progress, an ultrasound-guided injection into the shoulder can be very helpful, and performing it under ultrasound guidance helps place it accurately. The plan is agreed with you.

Why assessment helps

A painful, stiff shoulder is worth assessing to confirm the diagnosis, exclude other causes, and put in place a plan that eases symptoms and supports recovery rather than simply waiting it out. If your shoulder has become painful and stiff, a specialist review can help.

Painful, stiff shoulder?

A specialist assessment, with ultrasound where helpful, can confirm frozen shoulder and offer treatment including a guided injection where appropriate

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